The most innovative aspect of our Pilot Project is to use EMR data to define NSAID usage and CVD outcomes. We will use EMR data to define a large cohort of RA and OA patients. We will create an ondemand registry to target biospecimen collection using discarded tissue from routine care. We have already demonstrated that such an approach is feasible for patients with RA (see Preliminary Data in the Approach Section). We have not yet demonstrated that we can define NSAID usage and CVD outcome with high sensitivity and specificity. If we are indeed able to define precisely NSAID usage and CVD outcome, then we will be in a position to conduct large, well-powered genomic studies later in the funding period.